T Nation

Blood Work Shows Low Ferritin Since Starting TRT

I just got my blood tests back since starting TRT,
Everything looking fine,
Hemoglobin 17.2
Hematocrit 50
My testosterone is a little high 1500
But my main concern is my ferritin has dropped 80 percent, from 200, to 40,
Has anyone experienced this and how can I fix it ?
Iv been feeling a bit tired past couple weeks and thought it was the stress of lockdown but it could be because of this low ferritin,

My serum iron is normal 142,
My transferin is normal 242
Saturation transfer 42percent,
Iron transfer capacity 341,

So only thing that’s low is the ferritin,
My Vit d3 is 30 aswell wich is border, I will up the dose,
Just got some more results through my cortisol is 24, Reference range 8 to 22,

What causes low ferritin when other labs look great or are even too high?

That usually points to an MTHFR mutation and having high heavy metals. You can also see high levels of homocysteine with this defect, as well as higher levels of copper and other metals.

From https://stopthethyroidmadness.com/iron/

Might be worth checking that out.

I think it’s more to do with TRT in my case,
As Iv been having blood work regularly every 3 months before TRT and ferritin was always in good range,
Iv seen some other people say the same thing that after starting TRT ferritin went right down,
But I couldn’t find the solution,

Have you donated blood recently?

Did you test your homocystein?

It is very unusual to see someone have high normal iron but low ferritin without some kind of methylation problem

No blood donated
I don’t think they tested homocysteine,
I think it’s pretty common I found old threads on tnation but just no solution!
Hopefully someone knows how to fix it,
I found some information that kind of explains the reason this happened and basically it says lower dose and should get back in range,

Take a chelated iron supplement. It’s not unusual for your red blood cell production to ramp up with the increased test levels, which can use up iron supplies in the body - and affect folate and B12 as well sometimes. Did you check your B12 or folate? Iron levels are tough to really know. Just like other minerals, serum levels are not a great picture because your body stores iron un a lot of places. So, you can still have okay levels in serum but have actually depleted the stores and soaren’t functioning right.

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Yes this makes sense, I watched a video from coach vigorous Steve and he said the same thing,
When your hemoglobin/ hematocrit goes up the ferritin can go down to try and compensate,

My b12 is in range and I’ll check if they tested folate,
I’ll lower my dose for now as I can see it’s to high at 1500>